CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ10489999
Regular
Feb 01, 2019

Sean Lawson vs. Zenith Insurance Company

This case involves a dispute over the permanent disability rating for applicant Sean Lawson's low back injury. The defendant, Zenith Insurance Company, argues that the Range of Motion (ROM) method used by the Qualified Medical Evaluator (QME) was inappropriate, and the Diagnosis-Related Estimates (DRE) method should have been applied as there was only one level of radiculopathy. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's finding that the ROM method was appropriate based on the QME's expert opinion and the AMA Guides' provision for its use with multi-level involvement. However, one Commissioner dissented, believing the DRE method was mandated given the lack of evidence for multi-level radiculopathy.

WCABPetition for ReconsiderationPermanent DisabilityApportionmentNon-industrial factorsDiagnosis-Related Estimates (DRE) methodRange of Motion (ROM) methodQualified Medical Evaluator (QME)AMA GuidesMultilevel radiculopathy
References
1
Case No. ADJ8611746
Regular
Feb 27, 2017

VILMA AGUILAR vs. SLATKIN RESIDENCE, STATE FARM INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The defendant argued the administrative law judge erred in awarding 17% permanent disability by relying on the applicant's treating physician over a qualified medical evaluator. The Board found the treating physician's opinion was well-supported by objective clinical findings and consistent with the diagnosis of lumbar radiculopathy. Therefore, the Board gave significant weight to the administrative law judge's findings and denied the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityPrimary Treating PhysicianQualified Medical EvaluatorMedical OpinionCredibility DeterminationsSubstantial EvidenceLumbar Radiculopathy
References
8
Case No. ADJ14808611
Regular
Sep 16, 2022

KATIE Y. LAM vs. COUNTY OF ORANGE, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns an applicant who sought reconsideration of a workers' compensation award denying her claim for neck injury. The Workers' Compensation Appeals Board granted reconsideration, amending the award to include injury to the cervical spine. This amendment was based on the substantial evidence from a Qualified Medical Examiner (QME) whose reports indicated C6 radiculopathy was causally related to the applicant's employment injury. The Board found the QME's opinion well-reasoned and not contradicted by other evidence.

Cervical radiculopathyQMEAOE/COEPetition for ReconsiderationFindings and AwardSubstantial evidenceCompensable consequenceApportionmentDeputy sheriff traineeAmbulatory imbalance
References
8
Case No. ADJ6945712
Regular
Nov 29, 2011

CLAY WELDON vs. WALLACE KUHL & ASSOCIATES, U.S. FIDELITY AND GUARANTEE COMPANY

The Workers' Compensation Appeals Board (WCAB) reversed an award of spinal surgery for applicant Clay Weldon. The WCAB found that the Agreed Medical Examiner (AME), Dr. Bruce McCormack, provided substantial medical evidence that the surgery was not reasonable or appropriate at this time. Dr. McCormack's opinion, based on the ACOEM Guidelines and his examination, concluded there was no instability or radiculopathy justifying surgery. The WCAB found the WCJ's reasoning for disregarding the AME's opinion insufficient and therefore rescinded the award.

Workers' Compensation Appeals BoardFindings and Awardindustrial injuryspinal surgeryAgreed Medical ExaminerACOEM Guidelinesutilization reviewsubstantial medical evidenceradiculopathysegmental instability
References
3
Case No. ADJ11027267
Regular
Feb 03, 2023

LUIS ROSALES vs. IRELAND TILE AND STONE INC., SEDGWICK 14779 SAN DIEGO

This case involves an injured tile setter, Luis Rosales, who claimed lumbar radiculopathy stemming from an admitted industrial lumbar contusion. The Workers' Compensation Appeals Board denied reconsideration of a prior order, upholding a finding of 0% permanent disability. This decision was based on the Qualified Medical Examiner's (QME) reports, which the Board found to be substantial evidence. The Board specifically rejected the applicant's argument that the QME's opinions were inconsistent, clarifying that the QME found the sacral cyst unrelated to the lumbar contusion, not that the symptoms were unrelated to the cyst.

Petition for ReconsiderationQualified Medical ExaminerPQMEDr. Sonusupplemental reportsubstantial evidencelumbar contusionsacral cystradiculopathypermanent disability
References
2
Case No. ADJ14216452
Regular
Sep 12, 2025

JAIME VILLANUEVA vs. DALEY'S DRYWALL & TAPING, INC.; ARCH INSURANCE

Applicant Jaime Villanueva sought reconsideration of a June 16, 2025 decision that found 0% permanent disability based on a Qualified Medical Examiner's report. The Appeals Board found the QME's report by Dr. Bruce Huffer to be unsubstantial due to its conclusory nature, lack of reasoning, and failure to discuss pertinent medical records from other physicians. Consequently, the Board granted the petition, rescinded the original decision, and returned the matter for further proceedings to properly develop the medical record regarding the applicant's lumbar spine injury and claimed radiculopathy.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPanel Qualified Medical ExaminerPQMERadiculopathyPermanent DisabilityDRE Lumbar Category IIAMA GuidesSubstantial Evidence
References
9
Case No. MISSING
Regular Panel Decision

Browne v. DiNapoli

The petitioner, a police officer, sought accidental and performance of duty disability retirement benefits after being injured in 2005. His applications were denied, and this denial was upheld after a hearing, finding he was not permanently incapacitated. The petitioner initiated a CPLR article 78 proceeding to challenge this determination. The court considered conflicting medical evidence, including the petitioner's evidence of a 30% shoulder loss of use and radiculopathy, and an orthopedist's report for the New York State and Local Retirement System concluding the petitioner was not disabled. The court ultimately confirmed the respondent's determination, citing substantial evidence from the orthopedist's rational and fact-based medical opinion.

Disability RetirementPolice Officer InjuryAccidental DisabilityPerformance of Duty DisabilityCPLR Article 78Medical IncapacitationConflicting Medical EvidenceOrthopedic EvaluationRadiculopathyShoulder Injury
References
4
Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
2
Case No. MISSING
Regular Panel Decision

Claim of Reddien v. Joseph Davis Inc.

Claimant suffered work-related injuries to his back and left wrist in July 1999, with a schedule loss of use of his left hand determined in 2001. In 2011, claimant sought treatment for lumbar radiculopathy. The employer’s workers’ compensation carrier filed a request to transfer liability for the claim to the Special Fund for Reopened Cases pursuant to Workers’ Compensation Law § 25-a. The Workers’ Compensation Board denied the transfer, ruling the case was never truly closed because the issue of permanency for the back injury had not been addressed. The Appellate Division affirmed the Board's decision, finding substantial evidence that the case was not truly closed and thus Workers’ Compensation Law § 25-a was inapplicable.

Workers' CompensationSpecial FundReopened CasesSchedule Loss of UseLumbar RadiculopathyPermanent Partial DisabilityBoard DecisionAppellate ReviewCausally Related InjuryMedical Opinion
References
5
Case No. MISSING
Regular Panel Decision

Palmer v. State University of New York Upstate Medical University

The claimant, an orthopedic hand surgeon, developed cervical radiculopathy and degenerative disc disease due to the physical strain of performing hand surgery and filed for workers' compensation benefits. His claim was controverted by the State University of New York Upstate Medical University and its carrier, as well as the Research Foundation of New York and its carrier. The Workers' Compensation Board determined that the claimant was a dual employee of both the University and the Foundation and that his condition constituted a causally related occupational disease. The University and its carrier appealed this decision. The appellate court affirmed the Board's findings, concluding there was substantial evidence to support both the dual employment status and the existence of a recognizable link between the claimant's condition and the distinctive features of his occupation.

Occupational DiseaseCervical RadiculopathyDegenerative Disc DiseaseDual EmploymentWorkers' Compensation BenefitsHand Surgery StrainMedical OpinionAppellate ReviewCausationEmployer Liability
References
8
Showing 1-10 of 15 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational